Special Enrollment Periods

For All Western Regions: Effective July 28, 2014

We’re announcing updates to special enrollment periods that affect your Individual & Family Plans (IFP) and Small Business Group (SBG) clients. Please share this information with your clients.

 

New qualifying events for IFP

Federal regulations now allow two additional qualifying events for a person enrolling in an IFP plan during a special enrollment period.

They are as follows:

  • He or she loses medically needy coverage under Medicaid.
  • He or she loses pregnancy-related coverage under Medicaid.

These two qualifying events are not applicable if the person lost coverage due to voluntary termination or termination due to failure to pay his or her premium.

The effective dates for these qualifying events are outlined in the below chart.

 

Enrollment and loss of minimum essential coverage for IFP and SBG

Western Region IFP and SBG enrollees can now enroll up to 60 days prior to the loss of their minimum essential health coverage. Western region IFP and California SBG enrollees still have as late as 60 days after loss of coverage to enroll. Arizona and Oregon SBG enrollees still have as late as 30 days after loss of coverage to enroll.

 

Effective Dates

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California Brokers

If you have clients eligible for special enrollment due to a qualifying event, including the two new events listed above, they can apply for a Health Net of California, Inc. or Health Net Life Insurance Company (Health Net) plan through Covered California.

If your clients are applying for a Health Net off-exchange plan, please instruct them to submit the appropriate Medicaid documentation, along with one of our current enrollment forms.

PPO enrollment form

HMO enrollment form

We are currently revising our paper enrollment form.

 

Arizona Brokers

If you have clients eligible for special enrollment due to a qualifying event, including the two new events listed above, they can apply for a Health Net of Arizona, Inc. or Health Net Life Insurance Company (Health Net) plan through the Arizona Health Insurance Marketplace.

If your clients are applying for a Health Net off-exchange plan, please instruct them to submit the appropriate Medicaid documentation, along with our current enrollment form.

We are currently revising our paper enrollment form.

 

Oregon/Washington Brokers

If you have clients eligible for special enrollment due to a qualifying event, including the two new events listed above, they can apply for a Health Net Health Plan of Oregon, Inc. (Health Net) plan through Cover Oregon.

If your clients are applying for a Health Net off-exchange plan, please instruct them to submit the appropriate Medicaid documentation, along with our current enrollment form.

We are currently revising our paper enrollment form.

 

All brokers:  For questions regarding this update, please contact your account manager.

 

 

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Mike Spasoff